Substance use: buprenorphine-naloxone combination: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Substance use: buprenorphine-naloxone combination

Sample item

Opioid substitution clinics often prescribe buprenorphine combined with naloxone as a sublingual tablet rather than buprenorphine alone. What is the reason for adding naloxone?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. It deters misuse by injection

Sublingual naloxone has poor bioavailability and has little effect when the tablet is taken as directed. If the tablet is crushed and injected, naloxone becomes active and precipitates withdrawal in a dependent person, discouraging diversion. Buprenorphine alone is often used for induction.

Option by option

  • A. It deters misuse by injection (correct)

    Correct. The combination is designed to reduce misuse by injection.

  • B. It prolongs the half-life of buprenorphine

    Naloxone does not change the half-life of buprenorphine.

  • C. It improves analgesia from buprenorphine

    Naloxone is an antagonist and does not augment analgesia.

  • D. It prevents hepatotoxicity

    Hepatotoxicity is not prevented by naloxone.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, It deters misuse by injection. Sublingual naloxone has poor bioavailability and has little effect when the tablet is taken as directed.

Why is "It prolongs the half-life of buprenorphine" not the answer?

Naloxone does not change the half-life of buprenorphine.

Why is "It improves analgesia from buprenorphine" not the answer?

Naloxone is an antagonist and does not augment analgesia.

Why is "It prevents hepatotoxicity" not the answer?

Hepatotoxicity is not prevented by naloxone.

What concept does this question test?

It tests Substance use: buprenorphine-naloxone combination in Psychiatry. If the tablet is crushed and injected, naloxone becomes active and precipitates withdrawal in a dependent person, discouraging diversion. Buprenorphine alone is often used for induction.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Substance use: buprenorphine-naloxone combination?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.